Skin thickening on mammography (differential)

The presence of skin thickening on mammography is variably defined, usually being more than 2 mm in thickness. It can result from a number of both benign and malignant causes. They include:

Malignant

• inflammatory breast cancer: one of the most concerning causes of skin thickening: this usually gives diffuse skin thickening
• locally invasive breast cancer: tends to give focal skin thickening
• lymphatic obstruction of metastatic axillary nodes
• certain metastases to the breast
• breast lymphoma

Benign

• infection: mastitis
• conditions causing fluid build up in the breast: tends to be bilateral although at times can be asymmetrical if the patient has been lying on a particular side prior to the mammogram
  • cardiac failure
  • renal failure 
  • hypoalbuminemia
• trauma to the breast 
  • mammary fat necrosis 
  • burns to the skin overlying the breast with scarring
• chronic graft-versus-host disease (GVHD)
• breast irradiation: tends to be most prominent around 6 months after irradiation
• certain dermatological conditions
  • pseudoxanthoma elasticum